Read this short article to see how home birth might be a better option this time, than a hospital birth.
Home Birth in Israel: The Positive Experience You're Looking For? Picture the scene, you are nearing your due date and your excitement is tangible. Every time you get a Braxton Hick, you wonder if this pregnancy is ever going to end? The day finally comes when you know it is time, those Braxton Hicks start to get regular and stronger and you know in your heart that there is no more nervous anticipation, there is work to be done, it’s your birthing day and you can’t wait to greet and hold your new baby in your arms. Your midwife comes to your home where she is already familiar and sets up her equipment. You and your midwife feel really comfortable with each other, almost like friends, as she has been caring for you throughout your pregnancy and already discussed everything she needs to know about you. Now your partner sets up the birthing pool, puts clean sheets on the bed and dims the lights. Candles are lit, soft music is playing, you put on your most comforting pyjamas or nightie and go into labourland. Wandering from room to room, you find the place and position that feels most comfortable as you journey through your labour, your midwife at your side, keeping an eye on you and your baby. Finding comfort in your sofa, kneeling on the rug, going in and out of your shower or birthing pool. You feel totally calm and at home, because you are at home and your mind can float off, without distractions, leaving your body to focus on the important work of birthing. Now let’s contrast this tranquil landscape with that of a typical hospital birth that you might have already gone through. Your normal birth at hospital in Israel probably included many of the following situations while you were in labor: Travelling in a car to the hospital - how is it possible to fold yourself into a car and endure a bumpy ride while your whole body is wracked with strong contractions and all you want to do is go on your hands and knees? Waiting to be seen by a midwife who may or may not be in a friendly mood and having to lie on that skinny hard bed in the kabbalah for what seems like forever Being asked tons of questions whilst you are in the throes of labor because the hospital staff don’t know you or your medical history Having an IV put in your arm as soon as you are admitted, ‘just in case its needed’ even if you are nearing the birth and can’t bear people interfering at that point Repeated vaginal exams from midwives and doctors, sometimes one after the other, sometimes from male doctors, sometimes performed roughly without due care and patience Continuous fetal heart monitoring; being strapped to a machine with tight belts on your abdomen for long periods of time, restricting your movement and often forcing you to stay in the bed – if the baby’s heartbeat is not absolutely perfect, that’s it, you are doomed to be stuck on that monitor till the final push. Multiple strangers (medical and support staff) coming in and out of your labor room as they please, even when you are pushing – like ‘Hello! Can I have some privacy here please?! This is a sacred moment, and not the time for re-stacking the shelves in my labor room”! Being pressured to have your waters broken and/or to start a Pitocin drip, because the labor is going slowly! Then having to argue and insist on your rights not to permit these procedures. Sometimes being separated from your baby, often for hours at a time - I mean it’s your baby, why can’t they just let you have her? (Each hospital has differing policies on Zero Separation) Let's compare with the possibilities a home birth experience can give you: Your birthing room will be calm, quiet and comfortingly familiar with few people and no strangers - you control who enters your birth scene, because it is your home. Instead of repeated vaginal exams, you will likely need very few, and those will be performed with the utmost care and respect. Most likely you will never need an IV - it will only be employed if and when your specific circumstances make it a medical necessity. Instead of continuous and restrictive fetal heart rate monitoring, your baby’s well-being will be assessed by intermittent listening-in with a hand help doppler, in whichever position or place you are comfortable with at the time. Not forgetting to mention the most amazing benefit of home birth: being able to deliver in a birthing pool – the ultimate mode of pain relief and relaxation in labor and not available in the vast majority of hospitals in Israel. Sounds like a dream? Actually, it’s reality for the vast majority of women who choose a home birth. Their births are seen to be quicker and smoother than a hospital birth. Why is this? Well, their natural state and hormonal flow are not interrupted by the stressful situations that arise in the strange environment of the hospital. A major factor for many women is having confidence in their care provider instead of having to meet and trust complete strangers to deliver their baby. Women feel more relaxed in their own home environment. This allows the labor to unfold naturally and easily in most cases. Their experiences are very positive, which is why these women nearly always choose a home birth for their subsequent births too. It feels more ‘organic’ to their life, there is no need to leave the home to give birth and it is very comforting to prepare the birth space at home beforehand for maximal spiritual and emotional enjoyment, YES enjoyment of the birth! In regard to hospital births, many women will put up or even be happy with the intrusions, because they are anxious to have a full medical team on standby in case of emergency, especially if they've had a complicated pregnancy. Or maybe, they simply can’t have or don’t wish for a home birth for a whole host of reasons. Giving birth in a hospital can be a great experience with wonderful midwives and doctors despite all the unwanted restrictions. I was a hospital-based midwife for many years, and I did my utmost to give women the best birth experience possible within the constraints of the hospital policies, and for the most part, my enterprise succeeded. However, for many women childbirth is a scary and intimidating experience that needs to be ‘endured’ in order to bring a child into the world. The impositions placed upon you during a healthy labor are too distressing and distracting for what is, for most births, a natural and straightforward process. You might have to expend valuable energy insisting on your rights to refuse intervention or to adopt a certain position. Or you may be bullied into submitting to procedures you were reluctant about, just to satisfy the medical staff. Your best plans may have been tossed out the window because of some strict hospital policy that isn’t actually relevant in your case. In this situation, you may have felt powerless to do anything, apart from to comply meekly. This may leave you feeling somewhat deflated, even traumatized, about the whole difficult experience. Childbirth is a rare lifetime event which leaves an indelible mark on the psyche of the birthing mother and has many long-term repercussions. At its best, birth can be transcendental; the mother experiencing a state of euphoria which is unique to childbearing. Furthermore, a great birth experience empowers the new mother, boosting her self-belief and her ability to mother her child. A miserable birth experience by contrast, often leaves the mother feeling defeated, weakening her self- confidence and her functioning as a new parent. So, for those of you who delivered their first baby in hospital, and felt let down by the experience, you might be considering that there is a different way. Home births are indeed the perfect opportunity for second time mothers to create a healing experience after a difficult or traumatic first birth. The home birth stories you hear from women are nearly always positive and empowering. Here’s a selection of quotes I have received from women about their home birth: "No lights, no personnel… just calm, quiet, peaceful" "My own space and one-on-one attention" "I need to trust the person who attends the birth and have nurtured a comfortable relationship" “It was the most beautiful, most spiritual experience of my life” “I don’t have to play by the hospital rules” “I love the freedom of movement that happens at home” This all sounds great, but what else is there to consider regarding home birth? Firstly, no, there is not a big mess afterwards to tidy up! Your midwife will run the laundry and take out the garbage on her way out! What about complications and emergencies? Well, all midwives carry a large amount of medical equipment and are trained in dealing with emergencies. Only women with a low risk pregnancy are legally allowed to birth at home with a midwife. These women with straightforward pregnancies having a planned home birth have a very slim chance of complications. Nevertheless, you need to know that a small percentage of women are transferred to the hospital before, during or after labor for the safety of mother or baby. Most of these transfers happen without panic, as a good midwife will transfer you before the developing situation becomes an emergency. Overall outcomes for planned home births are extremely favorable and safety statistics are comparable with a hospital birth (see this article from respected medical journal 'The Lancet' for a meta-analysis of half a million home births worldwide). It is important to add, that home birth is endorsed as a preferred option for low risk women in many countries, including Canada, the UK and The Netherlands. And while we’re talking about risk, let’s just weigh the risk of home birth against some of the risks that come with a hospital birth. The risk of hospital acquired infection is a very real one whereby mothers and babies can pick up nasty hospital borne infections. Which brings us to the microbiome – a whole topic in and of itself. The microbiome of babies born at home has been proven to be far healthier than that of hospital born babies. A robust microbiome provides long term benefits to a child’s immune system and overall health. There's a known phenomenon in hospitals called 'The Cascade of Interventions'. A small intervention often leads to further required interventions and results in a c-section which could have been otherwise avoided. Your midwife, as dedicated as she may be, is often running between three different labour rooms. Sometimes, when you need her most, she is nowhere to be found, being busy delivering someone else’s baby elsewhere. (That is why all mothers receive a Pitocin injection after birth in the hospital, to guard against postpartum hemorrhage. Your midwife is not guaranteed to be nearby at all times after the birth, to check on your postpartum bleeding.) So as with all big decisions in life, there are pros and cons for each possibility, home and hospital. If you are interested in home birth, it is important to do your own research and speak to as many people as you need (including doctors) before you make your final informed decision. In home birth, you, the mother, takes responsibility for your labor and birth and you do not hand over your body for the hospital staff to ‘take care of’ and do as they wish. It’s not only about having your candles and a bath. You realize that it’s your body, your baby, your birth and that your physical and mental preparations are essential in helping you get through the hard work of childbearing. But when planned and carried out with commitment and in co-operation with your trusted midwife, it can be a truly healing and transformative experience. -- About The Author Sarah Seymour is a UK and Israel qualified midwife with over 20 years’ experience caring for mothers and delivering babies in hospitals and at home. Sarah attends births in the Jerusalem area, surrounding Yishuvim, Bet Shemesh and as far North as Petach Tikva and the Shomron. She believes in classic Midwifery, which takes the best from medical knowledge, and uses that to enhance an evidence based, midwife led, pregnancy and childbirth experience. In her interactions with clients, she focuses on attending to the emotional, social and spiritual aspects of pregnancy and birth as well as maximizing the health and wellness of the woman and her baby.
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